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They represent the pinnacle of achievement, but also a thousand "Starry Nights" never painted. We view them as beings far above the realm of us mere mortals, yet at the same time we intimately identify with them.

Such is the nature of the gift and curse that represents our illness. To know them is to know ourselves …

I’m hard at work right now on a book on bipolar. This would supplant the one that came out nearly nine years ago, based on a manuscript I turned in ten years ago.
This time, I’m going the self-publishing route, a series of short books (I see six, right now), that will add up to a rather large one. So it occurred to me: Why don’t I, from time to time, report what I’m working on?
Right now, I’m putting together two chapters that trace the evolution of our modern understanding of mood disorders. The story begins with Emil Kraepelin, who coined the term, manic-depression. In 1921, he wrote:
Manic-depressive insanity ... includes on the one hand the whole domain of so-called periodic and circular insanity, on the other hand simple mania, the greater part of the morbid states termed melancholia and also a not inconsiderable number of cases of amentia.
In other words, manic-depression also included unipolar depression. Plus "colorings of mood" that bled into personality.
Kraepelin is regarded as the father of diagnostic psychiatry, but by the time the American Psychiatric Association decided to compile a diagnostic bible, Freud was the dominant force in the US.
The DSM-I of 1952 and its successor the DSM-II of 1968 both preserved the general shape of Kraepelin’s manic-depression, but they overlaid it with a thick layer

If any of you ate chocolate this Valentine’s day, most likely it wasn’t in the company of a loved one. The odds hardly favor us being in long-term loving relationships, and a lot of us have just given up.
After all, we can be rather challenging to get along with.
Really? More so than the general population?
Maybe it’s time to rethink the notion that we are not relationship material. Someone out there, after all, is bound to take great delight in our strange and beautiful minds.
The catch is finding that special someone. “Normal” implies there are a lot more of “them” than there are “us.” I got an insight into this last year when I tried online dating. A friend of mine suggested that a more grounded type of woman would make a suitable complement for what I would optimistically describe as my essence of endearing lunacy.
Indeed, I did meet some very lovely and interesting women. Only they found me uncomfortably weird and I found them depressingly normal. My guess is these women were looking for a retired lawyer who played golf. Here I was, a fringe writer who played didgeridoo.
What I got out of the experience was that I was looking for a different type of woman, myself, a rare breed, an outlier. One outlier seeking a fellow outlier. You do the math.
That special someone, thoug

This day in 1809 witnessed the birth of both Lincoln and Darwin.
"The sight of a feather in a peacock's tail, whenever I gaze at it, makes me sick!" Darwin wrote.
What was going on in Darwin’s mind was this: Natural selection should have favored birds unburdened by excessive ornamentation. But these showy fellows were sitting ducks (close enough) for predators. What was the adaptive advantage to that?
Then came his aha! moment. These tails were chick magnets. The trade-off for the opportunity to mate was a shorter life.
Richard Dawkins, author of “The Selfish Gene,” put it this way: “The chicken is only an egg’s way of making another egg.”
The concept of evolutionary trade-offs has worked its way into mainstream medicine and psychiatry, and helps explain why disabling medical conditions get passed on from generation to generation.
Ronald Nesse of the University of Michigan notes, for instance, that panic and anxiety is rooted in our ancient fight-or-flight response. Better to be too anxious than dead.
The catch, though, is that what worked fine for stone age conditions may not be optimal for life in the modern world. Then again, we have our sixteenth President to consider …
"I am now the most miserable man living," the 31-year-old Li

How well do you understand 'up'? Diagnostic psychiatry, with its emphasis on symptom checklists, gives us the impression that mania and hypomania are objectively quantifiable states.
In reality, context is everything. To prove the point, here is a little quiz for you. Good luck …
Match the behavior to the state or trait …
1 - Splashing naked in a public fountain: a) mania, b) hypomania, c) normal.
2 - Dancing on tables, out of character: a) hypomania, b) hyperthymia, c) normal.
3 - Dancing on tables, part of your baseline personality: a) hypomania, b) hyperthymia, c) normal.
4 - Standing on your chair letting out a war whoop during the Final Four: a) hypomania, b) exuberance, c) normal.
5 - Wanting to run over all the shoppers in Walmart with your cart: a) normal, b) mania, c) mixed depression-hypomania.
6 - Actually running over shoppers in Walmart: a) mania, b) mixed depression-hypomania c) mixed depression-mania.
7- Feeling less depressed than before: a) depression, b) normal, c) hypomania.
Answers …
1 - a) This is classic mania. You are feeling wonderful, but you have lost your judgment, and your neighbors are about to dial 911. In a nudist camp during Mardi Gras, however, thi